Rapid response

Speed of response in an emergency can mean the difference between life and death. Clear communication is crucial but a 390 million programme to replace outdated analogue radio and communications systems with a new digital service across all NHS ambulance trusts in England came up against communication issues of its own.

When bombers struck London on July 7 2005, the response of the emergency services received universal praise. In the report that followed, it was revealed that this heroic effort was despite communication problems between paramedics on the scene, control rooms, hospitals and other emergency services.

Difficulties with the analogue system underground, limited coverage and range, lack of compatibility and obsolete equipment were among the problems, which were common to all 11 NHS ambulance trusts across England.

Communications within and between the emergency services failed on the day, said the report. The then Home Secretary, John Reid, vowed that things would improve. The Ambulance Radio Programme (ARP) is central to those improvements.

Once fully implemented, it will replace individual communication systems with a more reliable and secure network service between ambulance crews, control rooms and hospitals, seamlessly linking with other trusts, the police and the fire service.

It will also provide better coverage in rural areas and for hand-held radios. Ambulance trusts will also benefit from upgraded, modern, integrated dispatch systems.

A combination of vehicle-based radios, lightweight hand-held radios and new equipment in control rooms will be installed. This new system forms part of a 13-year, 390 million contract between the Department of Health and Airwave.

A central team was set up at the department to co-ordinate the programme, but it soon became clear that implementing a common system across 11 different trusts with thousands of eventual end-users was proving unwieldy and time consuming.

Within the overall programme, every trust had a set of projects to fulfil, from implementation of the digital system, building user confidence and eventual decommissioning of the old analogue equipment. Therein laid the problem!

Each of the small project teams was using different software and systems and with varying skills. Some had project management experience; others were operational staff that had been given the ARP job.

There was no common technology platform and although trusts had their own intranet sites, it was not possible to create a single site to which everyone involved had access.

We had no way of communicating and sharing plans, reports and information across the 11 trusts, explained Arumza Rashid of the DoH programme management office (PMO), which is co-ordinating the task. We had to develop plans remotely where trusts could not share them between one another and there was no consistency in the way it was being implemented.

A better way was urgently required to keep the programme on track. Enterprise project management (EPM) seemed the logical answer. However, because of the aggressive timescale set for implementation, it was crucial to win the hearts and minds of all those involved as quickly as possible.

The ARP team decided on a hosted EPM solution based on Microsoft Project Server 2007 and deployed by Program Framework, a project and portfolio management specialist.

With a user community spread out across the UK using disparate local infrastructures, hosting provided a significant benefit as local software installations became entirely unnecessary.

It also meant EPM could be deployed with no hefty upfront investment in software licences or infrastructure. A monthly pay-as-you-use arrangement meant the client only paid for as many users as were required at any one time ideal for a programme with a definite end date and with peaks and troughs of user numbers.

Realising that this would be a steep learning curve for the project teams around the country, clear explanatory presentations and information briefs were delivered explaining what EPM was, why the ARP was going down this route and how it would be implemented.

A seven-step phased approach was devised:

1. Identify requirements and configuration
2. Planning standards
3. Identify two pilot sites (South Western and London)
4. Central team and pilot site training
5. Pilot roll-out
6. Full roll-out
7. Additional configuration

This was reinforced through hands-on training sessions, allowing end-users to familiarise themselves with MS Project and the EPM system.

We had a very good steer from the programme team, said Gero Renker, director of Program Framework. They knew what they wanted and had a very pragmatic approach, focusing on key deliverables. This meant we were able to implement the solution very quickly just two months from start to finish.

Once the EPM system was up and running, it provided a central pool for all the documents, plans, information and updates as well as an individual workspace for each Trust containing their own documents, risks and issues.

A central team site was created to support communication with the project teams through announcements, event calendars and discussion groups, doing away with endless email threads and providing a platform for sharing best project management practice.

Automated reporting has allowed the PMO to produce fortnightly programme status dashboards for all stakeholders, compiled from checkpoint reports submitted by each trust. The central team has access to the management of risks and issues for individual project teams, flagging up any action that needs to be taken.

Everyone is firmly on board using EPM, said Arumza. It has certainly speeded things up because we have a common way of doing things and the visibility to share best practice and ideas and the programme implementation is back on schedule for completion in 2010.

Lessons learned 

• Simplicity is key with a diverse and large project community it is important to implement collaboration and reporting processes that are basic enough to be adopted by everybody.
• Adopting pilot sites is a great way to phase the go live stage and they can also become your advocates.
• Within a large programme such as ARP, adequate technology is a must in order to provide visibility and control of the many component projects.
• With remotely based team members, it is also important to ensure that the technology platform is robust and speedy in order to incur benefits from the start.
• The investment for technology and expert advice will easily be recovered through increased efficiency and improved control of the programme overall.